Treat Shingles With Aciclovir

Aciclovir is an antiviral medication used to treat shingles (herpes zoster), a painful skin rash caused by reactivation of the varicella-zoster virus (the same virus that causes chickenpox). Aciclovir works by inhibiting viral DNA replication, reducing the severity and duration of the shingles rash and pain. It is most effective when started within 72 hours of the rash appearing. Through the NHS Pharmacy First service, a pharmacist can supply aciclovir for shingles without a GP appointment.

Adults: 800 mg five times daily for 7 days. The doses should be taken approximately every 4 hours during waking hours (e.g., 7am, 11am, 3pm, 7pm, 11pm). This is a higher dose and longer course than used for cold sores or genital herpes. Take with plenty of water to maintain adequate hydration and protect the kidneys. Aciclovir can be taken with or without food. The full 7-day course should be completed.

Antiviral treatment for shingles is most effective when started within 72 hours of the rash appearing. Early treatment reduces the severity and duration of the rash, accelerates healing, and — importantly — may reduce the risk of post-herpetic neuralgia (PHN), a chronic pain condition that can persist for months or years after shingles. If more than 72 hours have passed, treatment may still be considered if new blisters are still forming or if the patient is immunocompromised.

Yes, the NHS Pharmacy First service allows pharmacists to clinically assess shingles and supply antiviral medication including aciclovir. The pharmacist will confirm the diagnosis, assess the timing of the rash, and determine whether antiviral treatment is appropriate. Early assessment is important — visit the pharmacy as soon as you suspect shingles to maximise the chance of starting treatment within the critical 72-hour window. This is a free NHS service.

Common side effects include nausea, vomiting, diarrhoea, abdominal pain, and headache. Skin rash and photosensitivity may occur. Drink plenty of water during treatment, as high-dose aciclovir can occasionally affect kidney function if the body is dehydrated. Uncommon side effects include dizziness, fatigue, and confusion (more common in elderly patients or those with kidney impairment). Aciclovir is generally very well-tolerated.

Shingles can be very painful. Use regular paracetamol and ibuprofen (if suitable) for pain relief. Keep the rash clean and dry. Wear loose-fitting clothing over the affected area. Calamine lotion may soothe itching. Cool compresses can provide relief. If pain is severe, your pharmacist or GP may recommend stronger pain relief such as codeine-containing products or neuropathic pain medications (amitriptyline, gabapentin). Do not cover the rash with adhesive dressings.

You cannot catch shingles from someone with shingles. However, someone who has not had chickenpox (or the chickenpox vaccine) can catch chickenpox from direct contact with fluid from shingles blisters. The risk exists until all blisters have crusted over. Avoid contact with pregnant women who have not had chickenpox, newborn babies, and immunocompromised individuals until the rash has fully crusted.